Research Of Ancient Syndrome Differentiation Methods Of Thoracic Obstruction

PurposeDrew the outline of ancient syndrome differentiation methods of thoracic obstruction to provide reference for the modern research of thoracic obstruction.Methods(1) Collected relevant literature data.(2) Analysed the literature data related to the syndrome differentiation methods of thoracic obstruction, and analysed thoracic obstruction medical records with the help of the study of historical data and mind map.Results(1) Ancient traditional chinese medical practitioners mainly found the reason why thoracic obstruction disease happend with the theory of pathogenic cold and someone with phlegm and rheum, someone with channels and collaterals.(2) Analysed literature data which do not include medical records, and found that the ancient doctors arrived at a conclusion of syndrome of thoracic obstruction from characteristics of primary symptom of the patient, severity of primary symptom,the time when the disease attacked, group of disease symptoms, pulse condition, fever with cold aversion.By analyzing the medical records mind map, the study collected the most common information from the tcm four diagnostic which the Ming and qing dynasties doctors will concerned when they met the patient with different primary symptoms (heartache, chest pain, chest tightness). Besides primary symptom, doctors needed another 1-7 information to draw conclusion of syndrome.In addition to the thoracic obstruction symptoms, pathogeny, mood, symptoms reflecting the quality of life, the temporal information of symptom mattered. Part of the medical records did not report the position of abnormal pulse. In the qing dynasty, some doctors recorded tongue coating.(3) The initial understanding of thoracic obstruction syndrome was excess syndrome and then turned to syndrome of intermingled deficiency and excess. Most ancient physicians had given priority to take cold syndrome as conclusion of syndrome of thoracic obstruction, but also part of them realized the there’s a connection between thoracic obstruction with heat syndrome. The disease location was viscera or channels. In the Ming dynasty, physicians clearly put forward location of thoracic obstruction,which are lungs,liver, heart. Doctors in qing dynasty put forward new requirements of syndrome differentiation. They thought it is important to tell the primary syndrome and secondary syndrome.(4) Through the medical records research, the study found that the ancient physicians took the primary symptom or disease diagnosis as the breakthrough point.and adopted understanding of syndrome of thoracic obstruction, which recorded in an authoritative book that has the breakthrough point, as the basis syndrome. Then, physicians modified the understanding with the rest of the symptoms.(5) Ancient physicians made that clear whether there is deficiency syndrome or excess syndrome by temporal information of symptom, pathogeny, pulse, severity of primary symptom, spirit, treatment, the influence of the longstanding symptoms, etc.Accroding to pulse or treatment or season when disease happend, the ancient doctors can make clear whether patient is with heat syndrome.The patient whose disease happend in summer, with loose stools, bosom frowsty, white tongue coating, pulse string, affected by dampness. The patient with slippery pulse, expectoration affected by phlegm. When dampness meets phlegm, pulse and tongue becomes turbid and not clear. He who has problem of stomach acid refluxing affected by fluid-retention. He who has severe chest pain or long course of disease or spat purple blood affected by blood stasis.ConclusionThe initial understanding of thoracic obstruction syndrome was excess syndrome, which is cold syndrome, and then turned to syndrome of intermingled deficiency and excess. In the process of syndrome differentiation of thoracic obstruction, the primary symptom and disease diagnosis played important roly. Because the doctors took them as a clue, and found Conclusion of syndrome wrote in an authoritative book which in their memories, and took it as the preliminary understanding of syndrome. And then, with another 1-7 information from the tcm four diagnostic, the doctors will realize that patient is with deficiency syndrome or with excess syndrome or with both, and will tell whether there is heat syndrome or dampness, phlegmy, fluid-retention or blood stasis. These information from the tcm four diagnostic can be temporal information such as the year and month when the thoracic obstruction attacked and duration of the disease,drugs used, symptoms reflecting the quality of life (urine and stool, sleep, food and drink), pulse, tongue coating, pathogeny.